Hepatocellular Carcinoma (HCC)

Risk factors (globally, 3rd leading cause of cancer death, espec. in Africa & Asia)

  • Cirrhosis: present in 70–90% HCC cases
  • Infectious: HCV & HBV (~75%), HBV/HDV coinfection; HBV can cause HCC w/o cirrhosis
  • Toxic: EtOH (⅓ cases in U.S.), tobacco, aflatoxin from Aspergillus
  • Metabolic disorders: NASH, DM, autoimmune hepatitis, hemochromatosis

Screening (screen Pts w/ cirrhosis, chronic HBV or HCV infection)

  • Ultrasonography (U/S) + AFP q 6 mos; if high-risk may alternate U/S w/ MRI
  • If lesion found or increasing AFP, perform 3-phase contrast CT or MRI

Diagnosis

  • At least 3-phase ontrast-enhanced CT